KIMBERLY WYATT (NPI# 1770116394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770116394 |
| Entity Type | Individual |
| Full Name | KIMBERLY WYATT |
| Credential | MSW |
| Practice Address |
2600 Center St Ne Salem OR 97301-2669 |
| Mailing Address |
1805 Se 30th Ave Portland OR 97214-4934 |
| Practice Telephone | 5039472882 |
| Mailing Telephone | 5033201654 |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-02-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
L4367 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982223947 | Kimberly Lashawn Wyatt | Licensed Practical Nurse | 180 Autumn Chapel Way, Rochester, NY 14624-5304 | 2020-04-10 |
| 1538492301 | Kimberly Rene Wyatt | Massage Therapist | 3229 Broadway St Ste G, North Bend, OR 97459-2203 | 2009-09-11 |
| 1326024902 | Kimberly Sue Wyatt | Internal Medicine | 509 Se Riverside Dr Ste 303, Stuart, FL 34994-2579 | 2005-12-15 |
| 1245719079 | Kimberly Wyatt | Case Manager/Care Coordinator | 10 Tsienneto Rd, Derry, NH 03038-1505 | 2018-08-13 |
| 1194269019 | Kimberly Saphaire-dawn Wyatt | Counselor | 209 Milwaukee St, Mount Vernon, WA 98273 | 2016-12-12 |
| 1336579622 | Kimberly Wyatt | Chiropractor | 1670 Mckendree Church Rd, Suite 400 B, Lawrenceville, GA 30043-4107 | 2013-11-22 |
| 1538490297 | Kimberly Anne Wyatt | Physician Assistant | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2010-01-20 |
| Street Address |
2600 CENTER ST NE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-2669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407857295 | Charles J Rim | Dentist | 2600 Center St Ne, Salem, OR 97301-2669 | 2005-08-03 |
| 1467059782 | Lucas Arcoverde | Nurse Practitioner | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-10-08 |
| 1548875834 | Mona Keivani | Pharmacist | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-09-13 |
| 1689284739 | Nicole Humphrey | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-08-04 |
| 1033733027 | Doris Okoli | Nurse Practitioner | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-06-04 |
| 1679197370 | Kristopher Kurtis Adams | Psychologist | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-05-29 |
| 1275162711 | Tyler St. Clair | Social Worker | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-04-06 |
| 1689200784 | Sophia Jaeger-manson | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-03-20 |
| 1154956548 | Connie Jo Mickelson | Dietitian, Registered | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-03-06 |
| 1841824588 | Margherita Zaheera Vaulte | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939108 | Sara Jane Garofalo | Social Worker | Bil-behavioral Health Esp, 35 Congress Street, Salem, MA 01970 | 2020-07-06 |
| 1891321360 | Jacqueline Alice Senn | Social Worker | 5 Dove Ave, Salem, MA 01970-2944 | 2020-03-17 |
| 1336775113 | Karen A. Chambers Msw, Lcsw | Social Worker | 910 Capitol St Ne Ste D, Salem, OR 97301-1201 | 2020-03-12 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1144860958 | Be Still and Grow | Social Worker | 1265 Waller St Se, Salem, OR 97302-2830 | 2020-01-09 |
| 1821639147 | Christine Ann Featherstone | Social Worker | Chemawa Indian Health Center, 3750 Chemawa Road, Salem, OR 97305 | 2019-10-08 |
| 1205489531 | Melissa Whitney Humphries | Social Worker | 375 Taylor St Ne Bldg 1, Salem, OR 97301-8340 | 2019-07-16 |
| 1265091656 | Kimberly Ann Nixon | Social Worker | 4236 Bluff Ave Se, Salem, OR 97302-1812 | 2019-06-10 |
| 1548732183 | Angela Jameson | Social Worker | 1970 Roanoke Blvd Bldg 8, Salem, VA 24153-6404 | 2018-12-20 |
| 1346718780 | Julie N Tapper | Social Worker | 211 Lafayette St, Salem, MA 01970-4769 | 2018-11-04 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.